DOWNERS GROVE – When Dr. James Cole discharged from the Navy in 2000 after nine years of service, the need for surgeons like him in the U.S. military looked much different than it would just months later.

“I left active duty at that time thinking it was a peaceful world,” he said. “And less than a year later 9/11 happened, and that changed everything, and I got back on as a drilling reservist.”

At the time a nine-year veteran, Cole said he thought of the friends still in active duty who would be sent overseas and how they might need his service.

“A lot of them had children and were young and enlisted,” he said. “And I’m a trauma surgeon. There aren’t many of us in the military. And like no other time except maybe Vietnam, they’re going to need us.”

This month, Cole, the assistant director for trauma at Good Samaritan Hospital in Downers Grove, will deploy for his third tour of duty in the Middle East since rejoining as a Navy reservist more than 12 years ago.

He joined the Navy in 1988 as a medical student in Chicago, taking advantage of the Navy Health Professionals Scholarship Program to pay for school.

Over the years, the surgeon served as a physician member of a Marine Corps reconnaissance unit, U.S. Special Operations Command and on a Navy Reserve SEAL team. He has received highly specialized training as a military diver and paratrooper.

The 48-year-old Mount Prospect native has a wife and four children and now lives in DeKalb County.

As a surgeon in Downers Grove, Cole said the gruesome injuries from car accidents often resemble the wounds inflicted by fighting in Iraq or Afghanistan.

Though the injuries may be visually similar, the operating environment couldn’t be more different.

In his first tour to Afghanistan, Cole joined special operations troops as they pushed outward toward Pakistan’s border. The surgeries would often take place in a tent, with instruments and lighting powered by generators set up by Cole.

He made that first Afghanistan deployment in 2004, followed by a tour in Iraq in 2007.

“Afghanistan in 2004 was still the absolute wild, wild west,” he said. “It was as dangerous as can be. … It was very hostile.”

Unlike that deployment, this year, he will operate in a more managerial capacity overseeing several trauma efforts in the war-torn country.

The U.S. has much more military infrastructure built there than it did nine years ago, and he expects to have more access to email and phone.

Cole knows what’s ahead, having gone through two deployments already, and said leaving behind family is the hardest part.

“I know how unpleasant it can be,” he said. “But I’m ready.”

His family also is likely as ready as a family can be. They moved 10 times when he was on active duty, and he was sent abroad many times before the three Middle East tours.

“The military wife is really a special person,” he said. “I have been gone so many times … I’d leave for a month or months at a time, sometimes with only a few hours notice, and she’d just [take care of everything].”

At 48, Cole is old for the military, and this could be his last deployment.

“Young people who look at me say ‘He’s old enough to be my dad,’” he said. “But I got a little left, so I’m still in and we’ll see what happens.”